The powerful hurricane lashes the Caribbean leaving a trail of devastation in Haiti, where at least 22 people killed.

Hurricane Matthew, the fiercest Caribbean storm in nearly a decade, made landfall in the Bahamas on Wednesday after battering Haiti, Cuba and the Dominican Republic with torrential rains, killing at least 26 people.

The hurricane, which the United Nations said has caused the worst humanitarian crisis to hit struggling Haiti since a devastating 2010 earthquake, whipped the country, and also Cuba, with 230km-per-hour winds on Tuesday, pummelling towns, farmland and resorts.

In the United States, more than 1.5 million people were urged to evacuate the southeastern coast and Florida Governor Rick Scott warned residents to prepare for a possible devastating direct hit.

Hundreds of thousands of people were evacuated from the path of the storm, which caused severe flooding and killed four people in the Dominican Republic, as well as at least 22 in Haiti.

The storm carved a path of devastation through western Haiti, destroying houses, dumping boats and debris on coastal roads, and heavily flooding residential areas.

Some 80 percent of homes were damaged in Haiti’s Sud Department, which has a population of more than 700,000, a government official said in a meeting with UN officials. About 11,000 people were in shelters in the province.

In the town of Jeremie, people were cooking and sleeping outside because most houses were either knocked down or severely damaged. Similar scenes were reported across the coastal towns of the south.

Haiti, the poorest country in the Americas, had been set to hold a repeatedly postponed presidential election on Sunday, but the country’s electoral council delayed it again in the aftermath of Matthew. No new date has yet been set.

"They are telling us that they have lost everything, including their crops, " Al Jazeera’s Theresa Bo, reporting from Ganthier in Haiti, said.

"UNICEF is saying four million children are at risk of going hungry because of the amount of crops that have been lost, and the death toll is expected to increase in the coming hours."

The US government said it was ready to help the afflicted and about 300 US Marines set off on the USS Mesa Verde to provide disaster relief in Haiti.

"The UN representative here says this is the worst natural disaster to hit Haiti since the earthquake in 2010," our correspondent said.

"In a country as fragile as Haiti, when a natural disaster like this hits, it tends to be deadly."

There were no immediate reports of deaths or casualties in Cuba, where the government had emphasised hurricane preparation. But Matthew did thrash the tourist town of Baracoa in the province of Guantanamo, gutting many houses.

The storm passed close to the disputed US naval base and military prison there.

Downgraded to Category Three

Matthew was a Category Four hurricane through Tuesday but was downgraded to Category Three on Wednesday, the Miami-based National Hurricane Center (NHC) said .

Maximum sustained winds eased to about 193kph but NHC said the hurricane was likely to strengthen again slightly in the coming days.

The storm is expected to near the US east coast of Florida on Thursday.

"Everyone in our state must prepare now for a direct hit," Scott said at a news conference. "If Matthew directly impacts Florida, the destruction could be catastrophic and you need to be prepared."

Hurricane and tropical storm warnings were extended along the east coast of Florida as the storm moved north.

Tropical storm or hurricane conditions could affect parts of Georgia, South Carolina, and North Carolina later this week, even if the centre of Matthew remains offshore, NHC said.

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